DIAPHRAGM /

A diaphragm is a shallow, dome-shaped cup made of latex or silicone. (Honestly, it looks like Meg Griffin's hat on The Family Guy. Except it's off-white and only a few inches in diameter.) You insert the diaphragm into your vagina. Then it covers your cervix and keeps sperm out of your uterus. One super important thing to remember: For a diaphragm to work effectively, you need to use it with spermicide.
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Comfortable with your body

If you're not okay with putting your fingers inside yourself, a diaphragm probably isn't for you. It's a little like putting in a tampon, though: If you can do that, you can probably manage a diaphragm.

It takes discipline

You've got to remember to insert your diaphragm each and every time you have sex, so it takes a bit of self-discipline and planning. But at least you can carry it with you in your purse if you want.

Allergy issues

If you're allergic to silicone or spermicide, you shouldn't use a diaphragm.

Not while you're bleeding

Don't use a diaphragm while you're having your period.

The pregnancy question

You'll be able to get pregnant as soon as you stop using the diaphragm. So protect yourself with another method right away.

Don't take our word for it. Check out the videos above to hear women and men talk about their experiences with the diaphragm.

With proper care—and if you don’t gain or lose a lot of weight—you can keep your diaphragm for up to ten years, making it a great birth control value for your buck at the equivalent of 42 cents to $2.08 a month (plus the cost of spermicide).

Prices:

Without insurance: Depending on your income, you may be able to go to a low-cost clinic to get the diaphragm at reduced cost. BTW, open enrollment through the Health Insurance Marketplace is over for 2015, but some people are still eligible for special enrollment. Find out if you could be one of them.

The full price of the diaphragm can range from $25 - $40; some clinics may charge extra for a fitting fee. To see how this translates over a year, here’s what it would cost to pay for a diaphragm month-to-month at full price:

A diaphragm can be inserted just before sex, but it can also go in hours before you get to it so that it doesn't get in the way of the moment. But no matter when it goes in, you have to be sure to leave it in for at least six hours after you have sex. If you're going to have sex again that day, just leave the diaphragm in place and insert more spermicide way up in your vagina. Just don't leave your diaphragm in for more than 24 hours.

Before you put it in

Add about a teaspoon of spermicide to the inner part of the diaphragm, and spread a little of it around the rim, as well. (Not too much, or it’ll be too slippery to hang on to.) Options Gynol II is specifically designed for diaphragms, and comes with an applicator you can use if you’re going to have sex more than once within six hours (you’ll need to add additional spermicide). Any kind of contraceptive gel or spermicide will do, however, except for the film or insert/suppository types. Don’t forget to check the expiration date.

How to put it in

Inserting a diaphragm may sound difficult, but with a bit of practice, it's not so tough.

Here's the deal:

Wash your hands. Soap and water, no shortcuts.

Check your diaphragm for holes and weak spots. Filling it with water is a good way to check—if it leaks, you've got a hole, which sorta defeats the whole purpose.

Put a tablespoon or so of spermicide in the cup, and spread some around the rim, too.

Get comfy, like you're going to put in a tampon.

Separate the outer lips of your vagina with one hand, and use the other hand to pinch the rim of the diaphragm and fold it in half.

Put your index finger in the middle of the fold to get a good, firm grip. (And yes, you'll be touching the spermicide.)

Push the diaphragm as far up and back into your vagina as you can, and make sure to cover your cervix.

Having another go at it?

You need to leave the diaphragm in for six hours after sex. If you have sex a second time within those six hours, first insert more spermicide. (Ortho Gynol II comes with an applicator that measures how much you’ll need, and gets it where it needs to go.) Then the six-hour clock starts again, counting from the last time you have sex.

How to take it out

Of course, what goes in must come out. Here's how:

Wash your hands again.

Put your index finger inside your vagina and hook it over the top of the rim of the diaphragm.

Pull the diaphragm down and out.

Still having trouble? Ask your doctor about getting an inserter, or consider switching to another method.

Finally, take good care of your diaphragm and it can last up for several years.

There are positive and negative things to say about each and every method. And everyone's different—so what you experience may not be the same as what your friend experiences.

The Positive

The Negative

You can put a diaphragm in hours in advance

You can have sex as many times as you like while it's in

Neither you nor your partner should be able to feel it

Doesn't affect your hormones

Decreases the risk of pelvic inflammatory disease and tubal infertility

Can be used while breastfeeding

Some women have a hard time inserting it

Can cause vaginal irritation

Some women wind up getting frequent urinary tract infections

You have to use it every time you have sex, no matter what

If you're allergic to spermicide or silicone, you shouldn't use a diaphragm

Can get pushed out of place by large penises, heavy thrusting, or certain sexual positions

You need a prescription

Hard to remember to use if you’re drunk

We’re here to get this method working better for you. And if it still doesn’t feel right, we've got ideas for other methods. Just remember: If you change methods, make sure you’re protected while you switch.

...The diaphragm is irritating me.

The irritation could actually be from an allergy to spermicide. If the irritation is mild, you might try another type of spermicide. Also, you could be allergic to latex, the material that the diaphragm is made from. If this is the case, you may need to switch to another birth control method.

Still not working?

If the irritation is more severe or sticks around once you try different types of spermicide, think about trying a method that doesn’t require any, like the IUD, shot, implant, pill, ring, or patch.

Try a different method...

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...It’s hard to insert and/or remove.

This might get easier with practice. If you haven't yet read our section on how to use it, you might want to check that out.

Still not working?

If practice hasn't helped, you might want to choose a method you don't have to insert inside you. If you really want to stick with a barrier method, check out one that you don’t have to put inside you, like male condoms.

Try a different method...

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...I keep getting urinary tract infections.

Some women do get urinary tract infections from using the diaphragm. It might help if you pee before inserting the diaphragm and after you have sex. You might also check with your doctor to make sure your diaphragm fits correctly.

Still not working?

If you're still having UTIs and want to switch methods, you might want to consider a method you don't have to insert yourself each time you have sex. You might try the implant, patch, IUD, pill, or shot.

Try a different method...

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Still others say, “green contraception” means “hormone free.” We don’t dispute that that is one way to look at the issue. And fortunately, there are many contraceptives already on the market that are hormone free: condoms (male and female), ParaGard IUD, diaphragms, cervical cap, and the sponge.

But a lot more goes into a green stamp of approval. The ParaGard IUD is generally thought to be the “greenest” contraceptive. It’s hormone-free, long lasting (up to a decade embracing the reduce portion of the "reduce, reuse, recycle" mantra), made from small amounts of cheap, plentiful metal (copper), and 99% effective. If for whatever reason you don't feel like the IUD is right for you, choose another method. Because when it comes to having sex, the greenest thing you can do is use birth control.